| Doctor Name: | MR. JIM JOHN MIKITA |
| NPI Number: | 1386054633 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RPH |
| License Number: | 5302022413 |
| Business Practice Address: | 1801 Marketplace Dr Se Caledonia, MI - 493168506 |
| Business Phone Number: | 6166566110 |
| Business Fax Number: | |
| Mailing Address: | 4146 E Gables Ct Ne, GRAND RAPIDS |
| State: | MI |
| Postal Code: | 495259378 |
| Phone Number: | 6166566110 |
| Fax Number: | |
| NPI Enumeration Date: | 05/07/2014 |
| NPI Last Update Date: | 05/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1835P1200X |
| License Number: | 5302022413 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacist |
| Taxonomy Specialization: | Pharmacotherapy |
| Taxonomy Definition: | A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |